The Human Side of Healthcare
Partner with a consultant that is focused on dramatically improving the financial
well-being of the entire population without sacrificing benefits.
By partnering with a consultant that will dramatically improves the financial well-being of the entire population while simultaneously reducing the pressure to have to cost shift health care premiums, deductibles and coinsurance to the employees every year.
When healthcare prices inside of your plan go unmanaged, costs spiral out of control and become unsustainable for your employees. When deductibles are raised, co-pays are eliminated, and programs are implemented that don’t work, your members suffer the side effects. These side effects are the hidden costs and financial burden they carry around both on and off the job.
Shopping for healthcare services sounds easy on the surface but can be a challenge to implement. Furthermore members are often not incentivised to make smart decisions and unfortunately the quality of care if rarely discussed. This can lead to undesirable outcomes if left unmanaged.
Our scholarship program allows your members to receive their most expensive (and needed) prescription medication with no out-of-pocket cost all the while your company experiences a 50-70% savings for the exact same medication.
There are 25+ prescription allowance plans that your Pharmacy Benefit Manager can access to reduce your overall prescription costs. Many PBM contracts are poorly written and very rarely ever read. This inefficiency leads to an increase in your pharmacy spend because the PBM has kept these allowances as profit, at your employees expense.
By incentivising members to make informed decisions, we can drive behavior and lower cost. This empowers the organization to use higher quality (lower cost providers). This opportunity allows us to waive copays or deductibles for members in these situations.
Chasing network discounts has lead many organizations to unknowingly focus on a moving target. The most successful organizations have installed VIP tiers that allows them to give employees benefit choices and access to higher quality care.
Leverage our insight to realize savings opportunities hidden inside your company’s health plan. The health insurance plan can leveraged to help reach other company initiatives; like reducing employee turnover, stimulate the recruiting efforts, increasing the 401k match, or multiplying the company’s profitability.
Misaligned financial incentives have caused insurance carriers and third party administrators to take advantage of your health plan. This has caused your organization to unnecessarily overpay without providing any enhancement to the care your employees receive.
By properly managing how you finance healthcare employees can keep their future pay increases by eliminating trend increases which will reduce income inequality, improve affordable health care and deliver greater financial wellness.
This reduces administrative burden and creates no noise from participants. From an organizational view, the employees will love the program and Finance will recognize the new contribution to the bottom line because we specifically recommend that you and your department participate in the savings generated!
Transparency, consumerism, and shopping are always discussed in healthcare, but simply having your members know how much an MRI costs is not going to lower your healthcare spending and won’t improve outcomes. Your employees know five to ten different metrics about how healthcare works (think co-pays, deductibles, in-network, max out of pocket, etc.), and that’s fine. What’s not fine is for the people who are paid to manage the healthcare supply chain to also only know or talk about those items.
Healthcare increases lead you to cost shift to employees by increase their premium contributions, deductibles and out-of-pocket maximums. As a result, many employees are working for less take-home pay because medical and pharmacy costs can’t be controlled. The majority of America lives paycheck to paycheck, carry record amounts of debt and financial decisions impact their access to care.
Organizations have taken biased advice from industry insiders that make more money as you unnecessarily overpay for healthcare. This has compressed the expectations that Human Resources has had on how their health plan should perform. Over time this has caused “insurance solution fatigue”.
The insurance industry has pushed a narrative that there is nothing you can do to control health insurance claims cost. This has shifted executive focus away from the 80% of your costs (claims) and onto more easily understood things like admin fees (20% of cost). This has dissuaded the executive team from being involved.
Many of the traditional healthcare changes seem to only have incremental impact. Because change can lead to employee noise, many organizations sacrifice the important for the urgent. This causes businesses to neglect what they believe they cannot change and instead focus on what they know they can.
When employees have insurance questions, their immediate response is to contact HR. We make our team available to take on the bulk of those requests. We monitor all these employee interactions in a trackable communication portal that provides accountability and enforces service level agreements.
Through our sister company, Payworx, we simplify payroll, time and HR with a unified HCM platform powered by Kronos. Everything flows directly into your payroll; keeping earnings, deductions, and taxes up-to-date and accurate. For those that love their current payroll provider, we offer a benefit admin only option.
Insurance communication can be difficult, complex and risky for those that don’t have an insurance license and E&O coverage. That’s why we offer to create benefit guide, do employee presentations and assist with all enrollment processes to help streamline the employee benefit plan offering process.